| NPI | 1093770752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 17555) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 20385) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2014-06-20 |